Supportive care for colorectal cancer

Supportive care helps people meet the physical, practical, emotional and spiritual challenges of colorectal cancer. It is an important part of cancer care. There are many programs and services available to help meet the needs and improve the quality of life of people living with cancer and their loved ones, especially after treatment has ended.

Recovering from colorectal cancer and adjusting to life after treatment is different for each person. Recovery depends on the stage of the cancer, the type of treatments and many other factors. The end of cancer treatment may bring mixed emotions. Even though treatment has ended, there may be other issues to deal with, such as coping with long-term side effects.

Talk to your healthcare team about the following. They can suggest ways to treat, manage or help you cope with any problems you have.

Nutrition

Maintaining proper nutrition is an important part of life after colorectal cancer, especially because cancer and its treatments affect the digestive system. Most people can eat their normal diet after surgery and other treatments for colorectal cancer. Some people may need to adjust their diet because they have the following problems, which can affect their nutrition.

Diarrhea

Diarrhea is a common problem for people who have a bowel resection to treat colorectal cancer. Diarrhea is more likely to happen if a large amount of the large intestine is removed, such as with a total colectomy (all of the colon is removed).

Your large intestine normally absorbs water. When part of your large intestine, including the colon, is removed, it can’t absorb water normally. This leads to diarrhea. Having diarrhea because some of your intestine has been removed is called short bowel syndrome.

You can help manage diarrhea by making changes to your diet. Limiting certain foods and drinks, such as greasy foods, high-fibre foods, coffee, tea and alcohol, can help prevent diarrhea. Your healthcare team can also recommend medicines to help manage diarrhea.

Constipation

Surgery to treat colorectal cancer can change the structure and function of the intestine. The intestine can become narrow after a bowel resection. Muscles and nerves could also be damaged during surgery. These changes can affect the normal formation of stool and its movement through the large intestine, leading to constipation.

You can help manage constipation by drinking lots of fluids every day and being physically active. Laxatives and enemas can also be used to manage constipation.

Living with a colostomy or ileostomy

Colostomy creates a stoma (artificial opening) from the colon to the outside of the body through the abdominal wall. Ileostomy creates a stoma from the ileum (the last part of the small intestine) to the outside of the body through the abdominal wall. A colostomy or ileostomy can be temporary or permanent.

Not everyone with colorectal cancer will need a colostomy or ileostomy. It can be frightening for those who do need it. But you can adapt to having a colostomy or ileostomy and live normally.

It takes time and patience to learn how to live with a colostomy or ileostomy and care for the stoma. Specially trained healthcare professionals, called enterostomal therapists, will teach you what you need to know. Local or national ostomy groups and associations can also give you support and information.

Self-esteem and body image

How you feel about or see yourself is called self-esteem. Body image is your perception of your own body. For many people, body image and their perception of how others see them is closely linked to self-esteem.

Colorectal cancer and its treatments can cause the following body changes. Some of these changes can be temporary, others will last for a long time and some will be permanent:

skin problems and scars

hair loss

changes in body weight

having a colostomy or ileostomy

urinary incontinence

These changes can affect your body image and self-esteem. Talking about feelings may help some people cope with their changed body image. Support from other cancer survivors and professional counsellors may help.

Sexuality

Some treatments for colorectal cancer can cause sexual problems or make sex difficult. Some people may lose interest in having sex around the time of diagnosis and during treatment.

Talk to your doctor or healthcare team if sexual problems occur because of colorectal cancer and treatments. They can help you manage these problems. Some people find that counselling helps them cope with the effects that colorectal cancer and its treatments have on their sexual relationships. Sometimes medicines can help manage sexual problems.